In the face of conflict, climate-related hazards and public health
emergencies, countries face compounding risks that increase the need for
mental health and psychosocial support (MHPSS) preparedness. Estonia
presents a strong example of how capacity-building enables better MHPSS
preparedness and strengthens national mental health systems.
Less
than a third of WHO Member States report having a MHPSS preparedness
programme in place. To enable better MHPSS preparedness, WHO implements
interagency, multi-sectoral capacity building workshops and simulation
exercises — advancing knowledge and skills for MHPSS preparedness.
As
a result of the ongoing conflict in Ukraine, approximately 48,000
Ukrainian refugees have registered for temporary protection status in
Estonia to date — constituting the largest arrival of refugees in
Estonia’s history. Their arrival further increased the need for the
better coordinated delivery of good-quality mental health and
psychosocial support, which is vital for those who have been caught up
in conflict or other emergency situations. However, the MHPSS response
in Estonia was initially fragmented. Anniki Lai, Head, Mental Health
Department, Ministry of Social Affairs (Estonia) noted that “the
country’s mental health system was not prepared to receive such a large
number of refugees and had already been strained during the pandemic.”
Mapping and training service providers to deliver mental health services
Estonia’s
Ministry of Social Affairs and Social Insurance Board lead the
country’s MHPSS activities in close collaboration with WHO and other
partners. Efforts towards better MHPSS preparedness have brought the
added advantage of strengthening the country’s mental health system and
scaling up mental health services.
In partnership with WHO, Estonia’s Ministry of Social Affairs oriented service providers on Psychological First Aid (PFA)
and completed a mapping of MHPSS service providers. Over 33 Estonian
organizations and institutions from across various sectors including
social, education and health participated in the mapping.
Katrin
Aarma, MHPSS advisor, Mental Health Department, Ministry of Social
Affairs described how the “MHPSS mapping exercise, conducted for the
first time in Estonia, helped to foster a community of experts who had
previously worked in a fragmented way to assist refugees.”
Integrating MHPSS into national preparedness plans
In
addition to mapping mental health services and building the capacity of
service providers in PFA, Estonia participated in two WHO-led global
capacity building workshops and simulation exercises on MHPSS
preparedness that were made possible thanks to the support of USAID's Bureau of Humanitarian Assistance (BHA) as the primary donor. These events further catalysed national efforts to develop comprehensive MHPSS
preparedness plans across the country.
The Ministry of
Social Affairs conducted workshops on integrating MHPSS within crises
and contingency planning for representatives from national health and
social sectors. These workshops helped the government integrate MHPSS
activities within emergency preparedness plans, fostering better
readiness for future emergencies.
To ensure continued
collaboration among various agencies and stakeholders, the Ministry of
Social Affairs, UNHCR, IOM and WHO hosted a high-level MHPSS
conference and parallel workshops on MHPSS preparedness. With the
presence of both international and Estonian MHPSS practitioners, the
MHPSS conference provided a platform for practitioners to exchange best
practices and experiences—fostering shared learning.
The
Ministry of Social Affairs also facilitated the first MHPSS coordination
meeting in June 2023. Notably, Estonia is one of the first countries to
establish a MHPSS Coordination Group as part of national emergency
preparedness.
Speaking to the impact of Estonia’s work to
strengthen MHPSS preparedness, Katrin shared that “service providers now
understand that everyone has a role to play in supporting people
affected during a crisis, and the importance of working together to
address mental health needs.” To further build national capacities,
Estonia’s Ministry of Social Affairs and WHO are hosting a global MHPSS
Preparedness Workshop and Simulation in Estonia in September 2023.
WHO is working with other Member States and partners in the region and globally to make MHPSS an integral part of all emergency preparedness plans and to build the capacity of systems and services to provide quality mental health services ready for any challenge.
For more information, please contact Dr Fahmy Hanna (hannaf@who.int), Dr Brandon Gray (grayb@who.int) and Jason Maurer (maurerj@who.int).